Provider Demographics
NPI:1649416785
Name:WYMAN, NEILA COHALAN (LCSW, PA)
Entity Type:Individual
Prefix:MRS
First Name:NEILA
Middle Name:COHALAN
Last Name:WYMAN
Suffix:
Gender:F
Credentials:LCSW, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 W 80TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6351
Mailing Address - Country:US
Mailing Address - Phone:212-362-0148
Mailing Address - Fax:212-874-6814
Practice Address - Street 1:118 W 80TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6351
Practice Address - Country:US
Practice Address - Phone:212-362-0148
Practice Address - Fax:212-874-6814
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000687102L00000X
NYR0356361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical